Organization
FAIRHAVENS HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMEKA LINUS CHIKWELU OKAFOR (PRESIDENT)
(763) 222-4746
Entity
Organization
Contact information
Practice address
2608 87TH TRL N, BROOKLYN PARK, MN 55443-3742
(763) 222-4746
(763) 888-0075
Mailing address
2608 87TH TRL N, BROOKLYN PARK, MN 55443-3742
(763) 222-4746
(763) 888-0075
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
1077353-1-HCBS
MN
253Z00000X
In Home Supportive Care Agency
1077353-1-HCBS
MN
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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